In 2017 I wrote a textbook chapter on Dying Safely. No, not a contradiction in terms.
That chapter was one of my first incursions into the topic of patient’s rights and I did it by reaching out to clinicians (with the co-authorship of one of them) to remind doctors that a good death was possible if society and medicine could accept -again- death as part of the life cycle.
A preview of this chapter 27 takes the reader into the concept of “a Good Death” which is essentially an opportunity for patients to plan according to their wishes, exercise their autonomy and express their preferences about where and how they are treated while they die -of natural causes following an irreversible illnesses (I’m not talking assisted suicide).
Doing the related research for that chapter I was pleased to find that there are several ways to help these people if they and their families want to know their prognosis (what and when things will develop and reach crisis point). Because the inclination to hear brutally honest news varies across cultures, genders and age groups. I summarised the available alternative out-of-hospital services to prevent the ongoing medicalisation of dying, such as homely hospices and the patient’s own home. There is of course the Compassionate Communities movement contributing to make this happen.
A crucial aspect of this shift from hospital to community care is not only the conceptualisation but the financial assistance for the infrastructure and outreach psychosocial support. Some health systems already provide this, but in Australia we are still taking baby steps to transition to this approach that’s gaining popularity and acceptability in the eyes of the public .
I hope to see the transformation in place before or by the time I need those services.
August 2021.
Magnolia Cardona 